Search results for: cardiovascular events

Authors: R. P. Hewawasam, M. H. A. D. de Silva, M. A. G. Iresha

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In recent years childhood obesity has increased to pan-epidemic proportions along with a concomitant increase in obesity-associated morbidity. Birth weight is an important determinant of later adult health, with neonates at both ends of the birth weight spectrum at risk of future health complications. Consequently, infants who are born large for gestational age (LGA) are more likely to be obese in childhood and adolescence and are at risk of cardiovascular and metabolic complications later in life. Adipose tissue plays a role in linking events in fetal growth to the subsequent development of adult diseases. In addition to its role as a storage depot for fat, adipose tissue produces and secrets a number of hormones of importance in modulating metabolism and energy homeostasis. Cord blood leptin level has been positively correlated with fetal adiposity at birth. It is established that Asians have lower skeletal muscle mass, low bone mineral content and excess body fat for a given body mass index indicating a genetic predisposition in the occurrence of obesity. To our knowledge, studies have never been conducted in Sri Lanka to determine the relationship between adipocytokine profile in cord blood and anthropometric parameters in newborns. Thus, the objective of this study is to establish the above relationship for the Sri Lankan population to implement awareness programs to minimize childhood obesity in the future. Umbilical cord blood was collected from 90 newborns (Male 40, Female 50; gestational age 35-42 weeks) after double clamping the umbilical cord before separation of the placenta and the concentration of leptin was measured by ELISA technique. Anthropometric parameters of the newborn such as birth weight, length, ponderal index, occipital frontal, chest, hip and calf circumferences were measured. Pearson’s correlation was used to assess the relationship between leptin and anthropometric parameters while the Mann-Whitney U test was used to assess the differences in cord blood leptin levels between small for gestational age (SGA), appropriate for gestational age (AGA) and LGA infants. There was a significant difference (P < 0.05) between the cord blood leptin concentrations of LGA infants (12.67 ng/mL ± 2.34) and AGA infants (7.10 ng/mL ± 0.90). However, a significant difference was not observed between leptin levels of SGA infants (8.86 ng/mL ± 0.70) and AGA infants. In both male and female neonates, umbilical leptin levels showed significant positive correlations (P < 0.05) with birth weight of the newborn, pre-pregnancy maternal weight and pre pregnancy BMI between the infants of large and appropriate for gestational ages. Increased concentrations of leptin levels in the cord blood of large for gestational age infants suggest that they may be involved in regulating fetal growth. Leptin concentration of Sri Lankan population was not significantly deviated from published data of Asian populations. Fetal leptin may be an important predictor of neonatal adiposity; however, interventional studies are required to assess its impact on the possible risk of childhood obesity.

Keywords: appropriate for gestational age, childhood obesity, leptin, anthropometry

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Authors: Katrina Angeline Santos, Francis Mark Fernandez, Francheska Esmao

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Intervention is defined as a forcible interference by a state or states with power in the affairs of another state using force or the threat of force. On the other hand, a military intervention is an intervention, specifically used to define an intervention which uses force. With these, the authors realized a lack in the concept of intervention wherein it is an invited one.The authors wrote this paper to introduce a concept of intervention wherein the intervening state is offering assistance to the state in crisis which asked for one. The authors decided to make a contextual description of this phenomenon because of the lack of concepts regarding intervention between the idea of a single state performing a ‘heroic’ role of intervening in the crisis of another state. The problem that the authors would like to address is regarding the lack of availability in the concept of intervention wherein the state in crisis is seeking the assistance of another state. The authors utilized a contextual description approach to the study through the descriptive presentation of the series of events, by utilizing the news articles and news reports published, which happened in Ukraine and Crimea. This concept is further demonstrated through the utilization of a conceptual framework which shows the mutual relationship between the states. From the analysis of the behavior of Russia and its role in the Crimean Crisis 2014, the authors are able to coin the term, 'Caped Intervention' to describe an intervention of a state as a response to the invitation of assistance of a state in crisis in order for them to achieve their goals. This concept entails a mutual relationship between an intervening state and a sate in crisis. The concept of Caped Intervention describes the role of Russia as a Caped State or an intervening state observed through its action towards Crimea. This concept will help in the observation of the behavior of actors or states in events such as this. It will further help in analyzing the actors’ role in intervention by making it possible to classify the intervening acts into another concept.

Keywords: assistance, caped intervention, crisis, heroic

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Authors: Hsiao-Lin Fang

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The Patient Self-Determination Act is based on the belief that each life is unique. The act regards each patient as an autonomous entity and explicitly protects the patient’s rights to know and make decisions and choices while ensuring that the patient’s wish for a peaceful end is granted. Even when the patient is unconscious and unable to express himself/herself, the patient’s self-determination and its exercise are still protected under the law. The act also ensures that healthcare professionals (HCPs) have a specific set of rules to follow and complete legal protection when their patients are unable to express themselves clearly. This report is about a 55-year-old female patient who weighed 110 kg and was diagnosed with acute type A aortic dissection. The case was that the patient suddenly felt backache and nausea during sleep before daybreak and was therefore transferred to this hospital from the original one. After the doctor explained the patient’s conditions, it was concluded that surgery was necessary. However, the patient’s family was immediately against the surgery after having heard its possible complications. Nevertheless, the patient was still willing to receive the surgery. Being at odds with her family, the patient decided to sign the surgery agreement herself and agreed to receive the two surgical procedures: (1) ascending aorta replacement and (2) innominate artery debranching. After the surgery, the patient did not regain consciousness and therefore received computed tomography scanning of the brain, which revealed false lumen involving proximal left common carotid artery, left subclavian artery and innominate artery, and severe compression of the true lumen with total/subtotal occlusion in the left common carotid artery. On the following day, the doctor discussed two further surgical procedures: (1) endografting for descending aorta and (2) endografting for left common carotid artery and subclavian artery with the family. However, as the patient’s postoperative recovery of consciousness only reached the level of stupor and her family had no intention of subsequent healthcare for the patient, the family made the joint decision three days later to have the endotracheal tube removed from the patient and let her die a natural death. Suggestion: An advance directive (AD) can be created beforehand. Once the patient is in a special clinical state (e.g., terminal illness, permanent vegetative state, etc.), the AD can determine whether to sustain the patient’s life through ‘medical intervention’ or to respect the patient’s rights to choose a peaceful end and receive palliative care. Through the expression of self-determination, it is possible to respect the patient’s medical practice autonomy and protect the patient’s dignity and right to a peaceful end, thereby respecting and supporting the patient’s decision. This also allows the three sides: the patient, the family and the medical team to understand the patient’s true wish in the process of advance care planning (ACP) and thereby promote harmony in the HCP-patient relationship.

Keywords: intensive care unit patient, cardiovascular surgery, self-determination, advance directive

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Authors: Victor Vasques Ribeiro

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The Santa Cruz dos Navegantes beach is located in the city of Guarujá, in the central portion of the coast of the state of São Paulo. Next to this beach is located the Channel of the Port of Santos, configured as a source of plastic pellets for marine environments. On sandy beaches near the sources, especially during the winter and after cold front entrance events, the amounts of pellets can be very high. This study aimed to determine the influence of a cold front entry event of the winter of 2019 on the amount of pellets found on Santa Cruz dos Navegantes beach, besides assuming the proximity of the sources. During six consecutive collection campaigns, three of which were previous and three after the cold front entry peak, 30.0 square meters of surface sediments were sampled in each campaign. The color and shape of the pellets were determined to assume the length of the permanence of these granules in the marine environment and, consequently, the proximity of the sources. This beach was considered ideal for this type of research. The pellet pollution index (PPI) was from moderate to very high right after the peak of the cold front entry. The cold front peak event significantly influenced the amount of pellets found on the beach of Santa Cruz dos Navegantes. The factors that can bury the pellets in the sediments were classified as low when compared to other beaches in the region. Most of the pellets found were recently produced and lost to aquatic environments. Like the other beaches near Santos Bay, Santa Cruz dos Navegantes beach receives significant amounts of pellets that have nearby origins. Therefore, it was supposed that the activities of the Santos port complex are sources of pellets for the marine environment. This pollution can be further worsened in certain meteoceanographic events. The beaches of this region need to be constantly monitored and evaluated for pollution by pellets.

Keywords: beach, cold front, pellets, sources

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Authors: G. Hubert, S. Aubry

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The earth is constantly bombarded by cosmic rays that can be of either galactic or solar origin. Thus, humans are exposed to high levels of galactic radiation due to altitude aircraft. The typical total ambient dose equivalent for a transatlantic flight is about 50 μSv during quiet solar activity. On the contrary, estimations differ by one order of magnitude for the contribution induced by certain solar particle events. Indeed, during Ground Level Enhancements (GLE) event, the Sun can emit particles of sufficient energy and intensity to raise radiation levels on Earth's surface. Analyses of GLE characteristics occurring since 1942 showed that for the worst of them, the dose level is of the order of 1 mSv and more. The largest of these events was observed on February 1956 for which the ambient dose equivalent rate is in the orders of 10 mSv/hr. The extra dose at aircraft altitudes for a flight during this event might have been about 20 mSv, i.e. comparable with the annual limit for aircrew. The most recent GLE, occurred on September 2017 resulting from an X-class solar flare, and it was measured on the surface of both the Earth and Mars using the Radiation Assessment Detector on the Mars Science Laboratory's Curiosity Rover. Recently, Hubert et al. proposed a GLE model included in a particle transport platform (named ATMORAD) describing the extensive air shower characteristics and allowing to assess the ambient dose equivalent. In this approach, the GCR is based on the Force-Field approximation model. The physical description of the Solar Cosmic Ray (i.e. SCR) considers the primary differential rigidity spectrum and the distribution of primary particles at the top of the atmosphere. ATMORAD allows to determine the spectral fluence rate of secondary particles induced by extensive showers, considering altitude range from ground to 45 km. Ambient dose equivalent can be determined using fluence-to-ambient dose equivalent conversion coefficients. The objective of this paper is to analyze the GCR and SCR impacts on ambient dose equivalent considering a high number statistic of world-flight paths. Flight trajectories are based on the Eurocontrol Demand Data Repository (DDR) and consider realistic flight plan with and without regulations or updated with Radar Data from CFMU (Central Flow Management Unit). The final paper will present exhaustive analyses implying solar impacts on ambient dose equivalent level and will propose detailed analyses considering route and airplane characteristics (departure, arrival, continent, airplane type etc.), and the phasing of the solar event. Preliminary results show an important impact of the flight path, particularly the latitude which drives the cutoff rigidity variations. Moreover, dose values vary drastically during GLE events, on the one hand with the route path (latitude, longitude altitude), on the other hand with the phasing of the solar event. Considering the GLE occurred on 23 February 1956, the average ambient dose equivalent evaluated for a flight Paris - New York is around 1.6 mSv, which is relevant to previous works This point highlights the importance of monitoring these solar events and of developing semi-empirical and particle transport method to obtain a reliable calculation of dose levels.

Keywords: cosmic ray, human dose, solar flare, aviation

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Authors: Sujata Kulkarni, Udhav Bhosle, Vijaykumar T.

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Due to the closeness between seismic signals and non-seismic signals, it is vital to detect earthquakes using conventional methods. In order to distinguish between seismic events and non-seismic events depending on their amplitude, our study processes the data that come from seismic sensors. The authors suggest a robust noise suppression technique that makes use of a bandpass filter, an IIR Wiener filter, recursive short-term average/long-term average (STA/LTA), and Carl short-term average (STA)/long-term average for event identification (LTA). The trigger ratio used in the proposed study to differentiate between seismic and non-seismic activity is determined. The proposed work focuses on significant feature extraction for machine learning-based seismic event detection. This serves as motivation for compiling a dataset of all features for the identification and forecasting of seismic signals. We place a focus on feature vector dimension reduction techniques due to the temporal complexity. The proposed notable features were experimentally tested using a machine learning model, and the results on unseen data are optimal. Finally, a presentation using a hybrid dataset (captured by different sensors) demonstrates how this model may also be employed in a real-time setting while lowering false alarm rates. The planned study is based on the examination of seismic signals obtained from both individual sensors and sensor networks (SN). A wideband seismic signal from BSVK and CUKG station sensors, respectively located near Basavakalyan, Karnataka, and the Central University of Karnataka, makes up the experimental dataset.

Keywords: Carl STA/LTA, features extraction, real time, dataset, machine learning, seismic detection

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Authors: Sami M. Alshareef

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In the rapidly evolving energy landscape, the integration of renewable energy sources and the electrification of transportation are essential steps toward achieving sustainability goals. However, these advancements introduce new challenges, particularly in maintaining frequency stability due to variable photovoltaic (PV) generation and the growing demand for fast charging stations. The variability of photovoltaic (PV) generation due to weather conditions can disrupt the balance between generation and load, resulting in frequency deviations. To ensure the stability of power systems, it is imperative to develop effective under frequency load-shedding schemes. This research proposal presents an adaptive under-frequency load shedding scheme based on the power swing equation, designed explicitly for the IEEE-9 Bus Test System, that includes PV generation and fast charging stations. This research aims to address these challenges by developing an advanced scheme that dynamically disconnects fast charging stations based on power imbalances. The scheme prioritizes the disconnection of stations near affected areas to expedite system frequency stabilization. To achieve these goals, the research project will leverage the power swing equation, a widely recognized model for analyzing system dynamics during under-frequency events. By utilizing this equation, the proposed scheme will adaptively adjust the load-shedding process in real-time to maintain frequency stability and prevent power blackouts. The research findings will support the transition towards sustainable energy systems by ensuring a reliable and uninterrupted electricity supply while enhancing the resilience and stability of power systems during under-frequency events.

Keywords: load shedding, fast charging stations, pv generation, power system resilience

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Authors: Juan Carlos Rubio Romero, Francico Salguero Caparros, Virginia Herrera-Pérez

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No one is in the slightest doubt about the high levels of risk involved in work in the construction industry. They are even higher in structural construction work. The Critical Decision Method (CDM) is a semi-structured interview technique that uses cognitive tests to identify the different disturbances that workers have to deal with in their work activity. At present, the vision of safety focused on daily performance and things that go well for safety and health management is facing the new paradigm known as Resilience Engineering. The aim of this study has been to describe the variability in formwork labour on concrete structures in the construction industry and, from there, to find out the resilient attitude of workers to unexpected events that they have experienced during their working lives. For this purpose, a series of semi-structured interviews were carried out with construction employees with extensive experience in formwork labour in Spain by applying the Critical Decision Method. This work has been the first application of the Critical Decision Method in the field of construction and, more specifically, in the execution of structures. The results obtained show that situations categorised as unthought-of are identified to a greater extent than potentially unexpected situations. The identification during these interviews of both expected and unexpected events provides insight into the critical decisions made and actions taken to improve resilience in daily practice in this construction work. From this study, it is clear that it is essential to gain more knowledge about the nature of the human cognitive process in work situations within complex socio-technical systems such as construction sites. This could lead to a more effective design of workplaces in the search for improved human performance.

Keywords: resilience engineering, construction industry, unthought-of situations, critical decision method

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Authors: Muhammad Wahb

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Physical activity is increasingly recognized as a significant factor in maintaining optimal health and preventing chronic diseases. This research scrutinizes the long-term health benefits of sustained physical activity, employing a systematic review of epidemiological studies and randomized control trials conducted over the past decade. The study illuminates the protective effects of regular physical activity against cardiovascular disease, obesity, diabetes, and mental health disorders, with a special focus on the mechanisms involved. Furthermore, the paper provides insights into how public health initiatives can effectively promote physical activity among diverse populations, contributing to improved community health outcomes.

Keywords: physical activity, long-term health benefits, chronic disease prevention, public health

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Authors: Ana-María Gómez-Carvajal, Hernando Santamaría-García, Mateo Bernal, Mario Valderrama, Daniela Lizarazo, Juliana Restrepo, María Fernanda Barreto, Angélica Parra, Paula Torres, Diana Matallana, Jaime Silva, José Santamaría-García, Sandra Baez

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Higher levels of oxytocin are associated with better performance on social cognition tasks. However, higher levels of oxytocin have also been associated with increased levels of envy and schadenfreude. Considering these antecedents, this study aims to explore social emotions (i.e., envy and schadenfreude) and other components of social cognition (i.e. ToM and empathy), in women in the puerperal period and their respective partners, compared to a control group of men and women without children or partners. Control women should be in the luteal phase of the menstrual cycle or taking oral contraceptives as they allow oxytocin levels to remain stable. We selected this population since increased levels of oxytocin are present in both mothers and fathers of newborn babies. Both groups were matched by age, sex, and education level. Twenty-two parents of newborns (11 women, 11 men) and 15 controls (8 women, 7 men) performed an experimental task designed to trigger schadenfreude and envy. In this task, each participant was shown a real-life photograph and a description of two target characters matched in age and gender with the participant. The task comprised two experimental blocks. In the first block, participants read 15 sentences describing fortunate events involving either character. After reading each sentence, participants rated the event in terms of how much envy they felt for the character (1=no envy, 9=extreme envy). In the second block, participants read and reported the intensity of their pleasure (schadenfreude, 1=no pleasure, 9=extreme pleasure) in response to 15 unfortunate events happening to the characters. Five neutral events were included in each block. Moreover, participants were assessed with ToM and empathy tests. Potential confounding variables such as general cognitive functioning, stress levels, hours of sleep and depression symptoms were also measured. Results showed that parents of newborns showed increased levels of envy and schadenfreude. These effects are not explained by any confounding factor. Moreover, no significant differences were found in ToM or empathy tests. Our results offer unprecedented evidence of specific differences in envy and schadenfreude levels in parents of newborns. Our findings support previous studies showing a negative relationship between oxytocin levels and negative social emotions. Further studies should assess the direct relationship between oxytocin levels in parents of newborns and the performance in social emotions tasks.

Keywords: envy, empathy, oxytocin, schadenfreude, social emotions, theory of mind

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Authors: P. H. G. J. Pushpakumara, Andrew Dawson

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Introduction: Deliberate self harm (DSH) is a major public health problem globally. Suicide rates of Sri Lanka are being among the highest national rates in the world, since 1950. Previous DSH is the most important independent predictor of repetition. The estimated 1 year non-fatal repeat self-harm rate was 16.3%. Asian countries had considerably lower rate, 10.0%. Objectives: To calculate incidence of deliberate self-poisoning (DSP) and suicides, repetition rate of DSP in Kurunegala District (KD). To determine the pattern of repeated DSP in KD. Methods: Study had two components. In the first component, demographic and event related details of, DSP admission in 46 hospitals and suicides in 28 police stations of KD were collected for 3 years from January 2011. Demographic details of cohort of DSP patients admitted to above hospitals in 2011 were linked with hospital admissions and police records of next two years period from the index admission. Records were screened for links with high sensitivity using the computer then did manual matching which would have been much more specific. In the second component, randomly selected DSP patients (n=438), who admitted to main referral centre which receives 60% of DSP cases of the district, were interviewed to assess life-time repetition. Results: There were 16,993 DSP admissions and 1078 suicides for the three year period. Suicide incidences in KD were, 21.6, 20.7 and 24.3 per 100,000 population in 2011, 2012 and 2013. Average male to female ratio for suicide incidences was 5.5. DSP incidences were 205.4, 248.3 and 202.5 per 100,000 population. Male incidences were slightly greater than the female incidences, male: female ratio was 1.1:1. Highest age standardized male and female incidence was reported in 20-24 years age group, 769.6/100,000, and 15-19 years age group 1304.0/100,000. Male to female ratio of the incidence increased with the age. There were 318 (179 male and 139 female) patients attempted DSH within two years. Female repetitive patients were ounger compared to the males, p < 0.0001, median age: males 28 and females 19 years. 290 (91.2%) had only one repetitive attempt, 24 (7.5%) had two, 3 (0.9%) had three and one (0.3%) had four in that period. One year repetition rate was 5.6 and two year repetition rate was 7.9%. Average intervals between indexed events and first repetitive DSP events were 246.8 (SD:223.4) and 238.5 (SD:207.0) days among males and females. One fifth of first repetitive events occurred within first two weeks in both males and females. Around 50% of males and females had the second event within 28 weeks. Within the first year of the indexed event, around 70% had the second event. First repetitive event was fatal for 28 (8.8%) individuals. Ages of those who died, mean 49.7 years (SD:15.3), were significantly higher compared to those who had non-fatal outcome, p<0.0001. 9.5% had life time history of DSH attempts. Conclusions: Both, DSP and suicide incidences were very high in KD. However, repetition rates were lesser compared regional values. Prevention of repetition alone may not produce significant impact on prevention of DSH.

Keywords: deliberate self-harm, incidence, repetition, Sri Lanka, suicide

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Authors: Melanie Kerschner

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Language is our main means of social interaction. News journalism, especially opinion discourse, holds a powerful position in this context. Editorials can be regarded as encounters of different, partially contradictory relationships between discourse participants constructed through the editorial voice. Their primary goal is to shape public opinion by commenting on events already addressed by other journalistic genres in the given newspaper. In doing so, the author tries to establish a consensus over the negotiated matter (i.e. the news event) with the reader. At the same time, he/she claims authority over the “correct” description and evaluation of an event. Yet, how can the relationship and the interaction between the discourse participants, i.e. the journalist, the reader and the news actors represented in the editorial, be best visualized and studied from a cross-cultural perspective? The present research project attempts to give insights into the role of (media) culture in British, Italian and German editorials. For this purpose the presenter will propose a basic framework: the so called “pyramid of discourse participants”, comprising the author, the reader, two types of news actors and the semantic macro-structure (as meta-level of analysis). Based on this framework, the following questions will be addressed: • Which strategies does the author employ to persuade the reader and to prompt him to give his opinion (in the comment section)? • In which ways (and with which linguistic tools) is editorial opinion expressed? • Does the author use adjectives, adverbials and modal verbs to evaluate news actors, their actions and the current state of affairs or does he/she prefer nominal labels? • Which influence do language choice and the related media culture have on the representation of news events in editorials? • In how far does the social context of a given media culture influence the amount of criticism and the way it is mediated so that it is still culturally-acceptable? The following culture-contrastive study shall examine 45 editorials (i.e. 15 per media culture) from six national quality papers that are similar in distribution, importance and the kind of envisaged readership to make valuable conclusions about culturally-motivated similarities and differences in the coverage and assessment of news events. The thematic orientation of the editorials will be the NSA scandal and the reactions of various countries, as this topic was and still is relevant to each of the three media cultures. Starting out from the “pyramid of discourse participants” as underlying framework, eight different criteria will be assigned to the individual discourse participants in the micro-analysis of the editorials. For the purpose of illustration, a single criterion, referring to the salience of authorial opinion, will be selected to demonstrate how the pyramid of discourse participants can be applied as a basis for empirical analysis. Extracts from the corpus shall furthermore enhance the understanding.

Keywords: Micro-analysis of editorials, culture-contrastive research, media culture, interaction between discourse participants, evaluation

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Authors: A.Beril Tugrul, Selahattin Cimen

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Dependency of humanity on the energy is ever-increasing today and the energy policies are reaching undeniable and un-ignorable dimensions steering the political events as well. Therefore, energy has the highest priority for Turkey like any other country. In this study, the energy supply security for Turkey evaluated according to the strategic criteria of energy policy. Under these circumstances, different alternatives are described and assessed with in terms of the energy expansion of Turkey. With this study, different opportunities in the energy expansion of Turkey is clarified and emphasized.

Keywords: energy policy, energy strategy, future projection, Turkey

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Authors: L. Boyaci

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Two basic equipment of electrical power subsystem of space satellites are Power Conditioning Unit (PCU) and Power Distribution Unit (PDU). Today, the main switching element used in power equipment in satellites is silicon (Si) based radiation-hardened MOSFET. GaNFETs have superior performances over MOSFETs in terms of their conduction and switching characteristics. GaNFET has started to take MOSFET’s place in many applications in industry especially by virtue of its switching performances. If GaNFET can also be used in equipment for space applications, this would be great revolution for future space power subsystem designs. In this study, the effect of proton irradiation on Gallium Nitride based power transistors was investigated. Four commercial enhancement mode GaN power transistors from Efficient Power Conversion Corporation (EPC) are irradiated with 30MeV protons while devices are switching. Flux of 8.2x10⁹ protons/cm²/s is applied for 12.5 seconds to reach ultimate fluence of 10¹¹ protons/cm². Vgs-Ids characteristics are measured and recorded for each device before, during and after irradiation. It was observed that if there would be destructive events. Proton induced permanent damage on devices is not observed. All the devices remained healthy and continued to operate. For two of these devices, further irradiation is applied with same flux for 30 minutes up to a total fluence level of 1.476x10¹³ protons/cm². We observed that GaNFETs are fully functional under this high level of radiation and no destructive events and irreversible failures took place for transistors. Results reveal that irradiated GaNFET in this experiment has radiation tolerance under proton testing and very important candidate for being one of the future power switching element in space.

Keywords: enhancement mode GaN power transistors, proton irradiation effects, radiation tolerance

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Authors: Shantanu Majumder

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This paper attempts to explain the factors contribute in attracting and engaging rural women in Bangladesh toward political Islam that in many cases manifests itself in the form of violent extremism (VE). Bangladesh, the fourth largest Muslim majority country in the world, has been confronting the problem of VE in the name of Islam since a long. The political Islamists, explaining the events like military operations in Afghanistan and Iraq, anti-Muslim politics in neighboring India and Myanmar, Islamophobia in the West, and several other issues in their own way, have become to a vast extent successful in creating a high level of emotion, anger and a feeling of being oppressed worldwide among the ordinary Muslims masses. Half-hearted role of public intellectuals and political expediency of liberal political forces in explaining these events in a secular democratic way also facilitate the extremists to earn political dividend. VE was perceived as an all-male activism of the political Islamists’ in the past in Bangladesh. However, evidence in the recent times shows that there are sympathizers, recruiters, and perpetrators as well among the womenfolk in favor of VE-based political Islam. The first section in this paper sheds light on the way the political Islamists build rapport with and win over the heart of target women in countryside under the camouflage of preaching authentic Islam. This section also describes the role of family in involvement of women in VE. The second section discusses wide-ranging use of websites, facebook, laptop, mobile phones and several other means in the way to motivate and radicalize women. How the involvement with political Islamists brings changes in thinking process, lifestyle and family life of motivated women has been focused in the third section. The final section deals briefly with the way out relying on the argument that law and order forces alone cannot tackle this problem.

Keywords: Bangladesh, political Islam, violent extremism, women

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Authors: Bongani Clearance Thela

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It seems that theatre remains a practical method for mobilising people and their ideologies; and South African literature has strengthened over the years as a result of the events which took place during both the Apartheid and Post-Apartheid eras. Hence, the problem noted in this study is that, generally, many people seem to believe that the issues which were a concern during Apartheid times in South Africa no longer exist in Post-Apartheid South Africa, whereas, it is seems that they still do. Post-Apartheid playwrights such as Zakes Mda among others, explore these issues in their works. There are common themes between the two periods, for this reason, distinction can only be drawn in terms of the context. Therefore, this study explores solutions offered by the themes of protest, corruption and race in Zakes Mda’s Our Lady of Benoni. The study uses real events and Mda’s play to reveal that there is a reinvention of Apartheid times’ issues into Post-Apartheid times’ issues. Moreover, the theme of race is explored with reference to class issues. Also, the study aims at highlighting some distinctions between the Apartheid period and Post-Apartheid period as shown by the playwright, Zakes Mda’s fictitious version as seen in some of his characters in the play. Theatre in general has always protested, it is either against an issue or for an issue; therefore, this paper will also explore the various ways in which the theme of protest is undertaken in the study of theatre. Respectively, the paper looks in the literal protest found in Mda’s Our Lady of Benoni in order to provide critical understanding with regard to the notion undertaken in this study. The paper goes on to provide an alternative discussion of the theme of protest; it critically evaluates issues such as corruption and race in terms of class that the playwright, Mda addresses in his play. In conclusion, this paper will use other relevant examples other than Mda’s drama, Our Lady of Benoni, in order to prove that there is a reinvention of Apartheid issues in Post-Apartheid issues in South Africa.

Keywords: protest, corruption, race, class

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Authors: Elena Carbone, Chiara Meneghetti, Ivan Innocenti, Monica Musicanti, Paola Volpe, Francesca Pazzaglia

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Promoting environmental sustainability is becoming a priority for organizations. Little is known, however, on the extent to which green workplace behaviors are linked, alongside organizational determinants, and also to various employees’ individual characteristics. The BE-GREEN research project, in collaboration with Eni S.p.A., aimed at investigating the relationship between the adoption of green workplace behaviors and various employees’ job-related and broader individual characteristics as well as organizational determinants. A sample of 513 Eni employees was administered a survey assessing the adoption of green workplace behaviors and the management of events (e.g., near-miss, unsafe conditions, weak signals) that could anticipate the occurrence of incidents with a harmful environmental impact. The survey also assessed employees’ job-related (e.g., proneness toward behaving pro-environmentally at work) and general (e.g., soft skills, connectedness to nature and environmental awareness) characteristics and perceived organizational support (e.g., environmental culture, leadership). Results showed that the adoption of green workplace behaviors was associated with employees’ proneness toward behaving pro-environmentally at work, and these factors were, in turn, influenced by broader individual characteristics related to soft skills as well as a connectedness to nature and environmental awareness, along with perceived organizational support. The management of events potentially anticipating the occurrence of incidents with a harmful environmental impact was mainly associated with perceived organizational support. These findings highlight how, alongside organizational determinants, different employees’ individual characteristics influence their adoption of green workplace behaviors, with important implications for the development of interventions tailored to promote environmental sustainability in organizations.

Keywords: green workplace behaviors, soft skills, connectedness to nature, environmental awareness.

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Authors: Du Kim, Nelson Baro

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According to a report of International Atomic Energy Agency (IAEA), there are approximately 437 nuclear power stations are in operation in the present around the world in order to meet increasing energy demands. Indeed, nearly, a third of the world’s energy demands are met through nuclear power because it is one of the most efficient and long-lasting sources of energy. However, there are also consequences when a major event takes place at a nuclear power station. Over the past years, a few major nuclear accidents have occurred around the world. According to a report of International Nuclear and Radiological Event Scale (INES), there are six nuclear accidents that are considered to be high level (risk) of the events: Fukushima Dai-chi (Level 7), Chernobyl (Level 7), Three Mile Island (Level 5), Windscale (Level 5), Kyshtym (Level 6) and Chalk River (Level 5). Today, many people still have doubt about using nuclear power. There is growing number of people who are against nuclear power after the serious accident occurred at the Fukushima Dai-chi nuclear power plant in Japan. In other words, there are public concerns about radiation impacts which emphasize Linear-No-Threshold (LNT) Issues, Radiation Health Effects, Radiation Protection and Social Impacts. This paper will address those keywords by looking back at the history of these major nuclear accidents worldwide, based on INES. This paper concludes that all major mistake from nuclear accidents are preventable due to the fact that most of them are caused by human error. In other words, the human factor has played a huge role in the malfunction and occurrence of most of those events. The correct handle of a crisis is determined, by having a good radiation protection program in place, it’s what has a big impact on society and determines how acceptable people are of nuclear.

Keywords: linear-no-threshold (LNT) issues, radiation health effects, radiation protection, social impacts

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Authors: Natalia Oli, Abhinav Vaidya, Katja Pahkala, Gabriele Eiben, Alexandra Krettek

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The nutritional transition towards a high fat and energy dense diet, decreasing physical activity level, and poor cardiovascular health knowledge contributes to a rising burden of cardiovascular diseases in Nepal. Dietary and physical activity behaviors are formed early in life and influenced by family, particularly by mothers in the social context of Nepal. The purpose of this study was to explore knowledge, attitude and behavior of mothers regarding diet and physical activity of their pre-school children. Cross-sectional study was conducted in the semi-urban area of Duwakot and Jhaukhel communities near the capital Kathmandu. Between August and November 2014, nine trained enumerators interviewed all mothers having children aged 2 to 7 years in their homes. Questionnaire contained information about mothers’ socio-demographic characteristics; their knowledge, attitude, and behavior regarding diet and physical activity as well as their children’s diet and physical activity. Knowledge, attitude and behavior responses were scored. SPSS version 22.0 was used for data analyses. Out of the 1,052 eligible mothers, 962 consented to participate in the study. The mean age was 28.9 ± 4.5 years. The majority of them (73%) were housewives. Mothers with higher education and income had higher knowledge, attitude, and behavior scores (All p < 0.001) whereas housewives and farmers had low knowledge score (p < 0.001). They, along with laborers, also exhibited lower attitude (p<0.001) and behavior scores (p < 0.001). Children’s diet score increased with mothers’ level of education (p <0.001) and income (p=0.041). Their physical activity score, however, declined with increasing level of their mothers’ education (p < 0.001) and income (p < 0.001). Children’s overall behavior score correlated poorly with mothers’ knowledge (r = 0.009, p=0.003), attitude (r =0.012, p=0.001), and behavior (r = 0.007, p= 0.008). Such poor correlation can be due to existence of the barriers among mothers. Mothers reported such barriers as expensive healthy food, difficulty to give up favorite food, taste preference of others family members and lack of knowledge on healthy food. Barriers for physical activity were lack of leisure time, lack of parks and playgrounds, being busy by caring for children and old people, feeling lazy and embarrassed in front of others. Additionally, among the facilitators for healthy lifestyle, mentioned by mothers, were better information, family eating healthy food and supporting physical activity, advice of medical personnel regarding healthy lifestyle and own ill health. The study demonstrated poor correlation of mothers’ knowledge and attitude with children’s behavior regarding diet and physical activity. Hence improving mothers’ knowledge or attitude may not be enough to improve dietary and physical activity habits of their children. Barriers and facilitators that affect mothers’ practices towards their children should also be addressed due to future intervention.

Keywords: attitude, behavior, diet, knowledge, mothers, physical activity

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Authors: Jasmeet Kaur, Anup Singh, Shashikant Iyengar, Arun Kumar, Ira Sahay

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Latent autoimmune diabetes in adults (LADA) is an irreversible autoimmune disease that affects insulin production. LADA is characterized by the production of Glutamic acid decarboxylase (GAD) antibodies, which is similar to type 1 diabetes. Individuals with LADA may eventually develop overt diabetes and require insulin. In this condition, the pancreas produces little or no insulin, which is a hormone used by the body to allow glucose to enter cells and produce energy. While type 1 diabetes was traditionally associated with children and teenagers, its prevalence has increased in adults as well. LADA is frequently misdiagnosed as type 2 diabetes, especially in adulthood when type 2 diabetes is more common. LADA develops in adulthood, usually after age 30. Managing LADA involves metabolic control with exogenous insulin and prolonging the life of surviving beta cells, thereby slowing the disease's progression. This case study examines the impact of approximately 3 months of low-carbohydrate dietary intervention in a 42-year-old woman with LADA who was initially misdiagnosed as having type 2 diabetes. Her c-peptide was 0.13 and her HbA1c was 9.3% when this trial began. Low-carbohydrate interventions have been shown to improve blood sugar levels, including fasting, post-meal, and random blood sugar levels, as well as haemoglobin levels, blood pressure, energy levels, sleep quality, and satiety levels. The use of low-carbohydrate dietary intervention significantly reduces both hypo- and hyperglycaemia events. During the 3 months of the study, there were 2 to 3 hyperglycaemic events owing to physical stress and a single hypoglycaemic event. Low-carbohydrate dietary therapies lessen insulin dose inaccuracy, which explains why there were fewer hyperglycaemic and hypoglycaemic events. In three months, the glycated haemoglobin (HbA1c) level was reduced from 9.3% to 6.3%. These improvements occur without the need for caloric restriction or physical activity. Stress management was crucial aspect of the treatment plan as stress-induced neuroendocrine hormones can cause immunological dysregulation. Additionally, supplements that support immune system and reduce inflammation were used as part of the treatment during the trial. Long-term studies are needed to track disease development and corroborate the claim that such dietary treatments can prolong the honeymoon phase in LADA. Various factors can contribute to additional autoimmune attacks, so measuring c-peptide is crucial on a regular basis to determine whether insulin levels need to be adjusted.

Keywords: autoimmune, diabetes, LADA, low_carb, nutrition

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Authors: Ravshan A. Ibadov, Sardor Kh. Ibragimov

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Objective. The aim of the study was to optimize the protocol of cardiopulmonary resuscitation (CPR) after cardiovascular surgical interventions. Methods. The experience of CPR conducted on patients after cardiovascular surgical interventions in the Department of Intensive Care and Resuscitation (DIR) of the Republican Specialized Scientific-Practical Medical Center of Surgery named after Academician V. Vakhidov is presented. The key to the new approach is the rapid elimination of reversible causes of cardiac arrest, followed by either defibrillation or electrical cardioversion (depending on the situation) before external heart compression, which may damage sternotomy. Careful use of adrenaline is emphasized due to the potential recurrence of hypertension, and timely resternotomy (within 5 minutes) is performed to ensure optimal cerebral perfusion through direct massage. Out of 32 patients, cardiac arrest in the form of asystole was observed in 16 (50%), with hypoxemia as the cause, while the remaining 16 (50%) experienced ventricular fibrillation caused by arrhythmogenic reactions. The age of the patients ranged from 6 to 60 years. All patients were evaluated before the operation using the ASA and EuroSCORE scales, falling into the moderate-risk group (3-5 points). CPR was conducted for cardiac activity restoration according to the American Heart Association and European Resuscitation Council guidelines (Ley SJ. Standards for Resuscitation After Cardiac Surgery. Critical Care Nurse. 2015;35(2):30-38). The duration of CPR ranged from 8 to 50 minutes. The ARASNE II scale was used to assess the severity of patients' conditions after CPR, and the Glasgow Coma Scale was employed to evaluate patients' consciousness after the restoration of cardiac activity and sedation withdrawal. Results. In all patients, immediate chest compressions of the necessary depth (4-5 cm) at a frequency of 100-120 compressions per minute were initiated upon detection of cardiac arrest. Regardless of the type of cardiac arrest, defibrillation with a manual defibrillator was performed 3-5 minutes later, and adrenaline was administered in doses ranging from 100 to 300 mcg. Persistent ventricular fibrillation was also treated with antiarrhythmic therapy (amiodarone, lidocaine). If necessary, infusion of inotropes and vasopressors was used, and for the prevention of brain edema and the restoration of adequate neurostatus within 1-3 days, sedation, a magnesium-lidocaine mixture, mechanical intranasal cooling of the brain stem, and neuroprotective drugs were employed. A coordinated effort by the resuscitation team and proper role allocation within the team were essential for effective cardiopulmonary resuscitation (CPR). All these measures contributed to the improvement of CPR outcomes. Conclusion. Successful CPR following cardiac surgical interventions involves interdisciplinary collaboration. The application of an optimized CPR standard leads to a reduction in mortality rates and favorable neurological outcomes.

Keywords: cardiac surgery, cardiac arrest, resuscitation, critically ill patients

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Authors: Michael McTighe

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Background: The COVID-19 pandemic caused the cancellation of many large-scale in-person sporting events, which led to an increase in the availability of virtual ultra-marathons. This study intended to assess how participation in virtual long distances races relates to levels of physical activity for an extended period of time. Moreover, traditional ultra-marathons are known for being not only physically demanding, but also mentally and emotionally challenging. A second component of this study was to assess how psychological contructs related to emotion regulation and mental toughness predict overall performance in the sport. Method: 83 virtual runners participating in a four-month 1000-kilometer race with the option to exceed 1000 kilometers completed a questionnaire exploring demographics, their performance, and experience in the virtual race. Participants also completed the Difficulties in Emotions Regulation Scale (DERS) and the Sports Mental Toughness Questionnaire (SMTQ). Logistics regressions assessed these constructs’ utility in predicting completion of the 1000-kilometer distance in the time allotted. Multiple regression was employed to predict the total distance traversed during the fourmonth race beyond 1000-kilometers. Result: Neither mental toughness nor emotional regulation was a significant predictor of completing the virtual race’s basic 1000-kilometer finish. However, both variables included together were marginally significant predictors of total miles traversed over the entire event beyond 1000 K (p = .051). Additionally, participation in the event promoted an increase in healthy activity with participants running and walking significantly more in the four months during the event than the four months leading up to it. Discussion: This research intended to explore how psychological constructs relate to performance in a virtual type of endurance event, and how involvement in these types of events related to levels of activity. Higher levels of mental toughness and lower levels in difficulties in emotion regulation were associated with greater performance, and participation in the event promoted an increase in athletic involvement. Future psychological skill training aimed at improving emotion regulation and mental toughness may be used to enhance athletic performance in these sports, and future investigations into these events could explore how general participation may influence these constructs over time. Finally, these results suggest that participation in this logistically accessible, and affordable type of sport can promote greater involvement in healthy activities related to running and walking.

Keywords: virtual races, emotion regulation, mental toughness, ultra-marathon, predictors in performance

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Authors: Fatma Ahmed, Heba Mostafa, Bassem Ramdan, Azza El-Soussi

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Background: World Health Organization stated that by 2020 cardiac disease will be the number one cause of death worldwide and estimates that 25 million people per year will suffer from heart disease. Cardiac surgery is considered an effective treatment for severe forms of cardiovascular diseases that cannot be treated by medical treatment or cardiac interventions. In spite of the benefits of cardiac surgery, it is considered a major stressful experience for patients who are candidate for surgery. Prehabilitation can decrease incidences of postoperative complications as it prepares patients for surgical stress through enhancing their defenses to meet the demands of surgery. When patients anticipate the postoperative sequence of events, they will prepare themselves to act certain behaviors, identify their roles and actively participate in their own recovery, therefore, anxiety levels are decreased and functional capacity is enhanced. Prehabilitation programs can comprise interventions that include physical exercise, psychological prehabilitation, nutritional optimization and risk factor modification. Physical exercises are associated with improvements in the functioning of the various physiological systems, reflected in increased functional capacity, improved cardiac and respiratory functions and make patients fit for surgical intervention. Prehabilitation programs should also prepare patients psychologically in order to cope with stress, anxiety and depression associated with postoperative pain, fatigue, limited ability to perform the usual activities of daily living through acting in a healthy manner. Notwithstanding the benefits of psychological preparations, there are limited studies which investigated the effect of psychological prehabilitation to confirm its effect on psychological, quality of life and physiological outcomes of patients who had undergone cardiac surgery. Aim of the study: The study aims to determine the effect of prehabilitation interventions on outcomes of patients undergoing cardiac surgeries. Methods: Quasi experimental study design was used to conduct this study. Sixty eligible and consenting patients were recruited and divided into two groups: control and intervention group (30 participants in each). One tool namely emotional, physiological, clinical, cognitive and functional capacity outcomes of prehabilitation intervention assessment tool was utilized to collect the data of this study. Results: Data analysis showed significant improvement in patients' emotional state, physiological and clinical outcomes (P < 0.000) with the use of prehabilitation interventions. Conclusions: Cardiac prehabilitation in the form of providing information about surgery, circulation exercise, deep breathing exercise, incentive spirometer training and nutritional education implemented daily by patients scheduled for elective open heart surgery one week before surgery have been shown to improve patients' emotional state, physiological and clinical outcomes.

Keywords: emotional recovery, clinical recovery, coronary artery bypass grafting patients, prehabilitation

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Authors: Farshad Ghodoosi

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This article analyzes the effect of supervening events in contracts. Contracts serve an important function: allocation of risks. In spite of its importance, the case law and the doctrine are messy and inconsistent. This article provides a fresh look at excuse doctrines (i.e., force majeure, impracticability, impossibility, and frustration) with a focus on force majeure clauses. The article makes the following contributions: First, it furnishes a new conceptual and theoretical framework of excuse doctrines. By distilling the decisions, it shows that excuse doctrines rests on the triangle of control, foreseeability, and contract language. Second, it analyzes force majeure clauses used by S&P 500 companies to understand the stickiness and similarity of such clauses and the events they cover. Third, using computational and statistical tools, it analyzes US cases since 1810 in order to assess the weight given to the triangle of control, foreseeability, and contract language. It shows that the control factor plays an important role in force majeure analysis, while the contractual interpretation is the least important factor. The Article concludes that it is the standard for control -whether the supervening event is beyond the control of the party- that determines the outcome of cases in the force majeure context and not necessarily the contractual language. This article has important implications on COVID-19-related contractual cases. Unlike the prevailing narrative that it is the language of the force majeure clause that’s determinative, this article shows that the primarily focus of the inquiry will be on whether the effects of COVID-19 have been beyond the control of the promisee. Normatively, the Article suggests that the trifactor of control, foreseeability, and contractual language are not effective for allocation of legal risks in times of crises. It puts forward a novel approach to force majeure clauses whereby that the courts should instead focus on the degree to which parties have relied on (expected) performance, in particular during the time of crisis.

Keywords: contractual risks, force majeure clauses, foreseeability, control, contractual language, computational analysis

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Authors: Stephen W. Wang

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This research aims to explore the multi-faceted structure of airline passengers’ perception of airline sponsorship, and its impact on airline passengers and even consumers on airline brand preferences and brand equity. The connotation of this research is mainly divided into two parts. The first part of the research focuses on exploring the connotation and sub-dimensions of “air passengers’ perception of airline sponsorship”; the second part of the research focuses on integrating “air passengers’ perception on the multi-factor aspect of the corporate sponsorship, “brand transfer theory” and “brand theory”, explores the influence of airlines’ commitment to corporate sponsorship activities on the brand equity and brand preferences of airline passengers, and on passengers’ subsequent behavioral intentions . In addition, in order to clarify the differences between different types of corporate sponsorship activities and events in terms of "air passengers' perception of airline corporate sponsorship activities", brand transfer, brand preference, brand equity and behavioral intentions, this research also focuses on moderating effects of corporate sponsorship events. With the apply of multi-group structural equation model, it is hoped that the effectiveness of the sponsorship activities of airline companies will be improved. In terms of theoretical and practical implications, the aviation industry can follow the results of this research to understand which corporate sponsorship perceptions have a greater impact on consumers, which has important practical significance. The second part of the research project, from the consumer's point of view, understands whether airline corporate sponsorship activities influence behavioral intentions through brand transfer and brand recognition. Through the analysis of the intermediary effect of brand transfer, brand preference and brand equity, the results of this research can provide a more complete and powerful explanation for “why” airlines’ commitment to corporate sponsorship activities can affect airline passengers’ purchase intentions, which will help fill in the gap of the theoretical and practical research on "airline corporate sponsorship", and has its theoretical significance.

Keywords: airline, sponsorship, brand image transfer, brand preference

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Authors: Alfonsina Buoniconto

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The aim of this study is to investigate the degree of cross-linguistic and intra-linguistic variation in the encoding of motion events (MEs) in English and Italian, these being typologically different languages both showing signs of disobedience to their respective types. As a matter of fact, the traditional typological classification of MEs encoding distributes languages into two macro-types, based on the preferred locus for the expression of Path, the main ME component (other components being Figure, Ground and Manner) characterized by conceptual and structural prominence. According to this model, Satellite-framed (SF) languages typically express Path information in verb-dependent items called satellites (e.g. preverbs and verb particles) with main verbs encoding Manner of motion; whereas Verb-framed languages (VF) tend to include Path information within the verbal locus, leaving Manner to adjuncts. Although this dichotomy is valid altogether, languages do not always behave according to their typical classification patterns. English, for example, is usually ascribed to the SF type due to the rich inventory of postverbal particles and phrasal verbs used to express spatial relations (i.e. the cat climbed down the tree); nevertheless, it is not uncommon to find constructions such as the fog descended slowly, which is typical of the VF type. Conversely, Italian is usually described as being VF (cf. Paolo uscì di corsa ‘Paolo went out running’), yet SF constructions like corse via in lacrime ‘She ran away in tears’ are also frequent. This paper will try to demonstrate that such a typological overlapping is due to the fact that the semantic units making up MEs are distributed within several loci of the sentence –not only verbs and satellites– thus determining a number of different constructions stemming from convergent factors. Indeed, the linguistic expression of motion events depends not only on the typological nature of languages in a traditional sense, but also on a series morphological, lexical, and syntactic resources, as well as on inferential, discursive, usage-related, and cultural factors that make semantic information more or less accessible, frequent, and easy to process. Hence, rather than describe English and Italian in dichotomic terms, this study focuses on the investigation of cross-linguistic and intra-linguistic variation in the use of all the strategies made available by each linguistic system to express motion. Evidence for these assumptions is provided by parallel corpora analysis. The sample texts are taken from two contemporary Italian novels and their respective English translations. The 400 motion occurrences selected (200 in English and 200 in Italian) were scanned according to the MODEG (an acronym for Motion Decoding Grid) methodology, which grants data comparability through the indexation and retrieval of combined morphosyntactic and semantic information at different levels of detail.

Keywords: construction typology, motion event encoding, parallel corpora, satellite-framed vs. verb-framed type

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Authors: Liane Marcia Freitas Silva, Fernando Augusto Silva Marins, Maria Silene Alexandre Leite

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The adoption of a network structure, like in the supply chains, favors the increase of dependence between companies and, by consequence, their vulnerability. Environment disasters, sociopolitical and economical events, and the dynamics of supply chains elevate the uncertainty of their operation, favoring the occurrence of events that can generate break up in the operations and other undesired consequences. Thus, supply chains are exposed to various risks that can influence the profitability of companies involved, and there are several previous studies that have proposed risk classification models in order to categorize the risks and to manage them. The objective of this paper is to analyze and discuss thirty of these risk classification models by means a theoretical survey. The research method adopted for analyzing and discussion includes three phases: The identification of the types of risks proposed in each one of the thirty models, the grouping of them considering equivalent concepts associated to their definitions, and, the analysis of these risks groups, evaluating their similarities and differences. After these analyses, it was possible to conclude that, in fact, there is more than thirty risks types identified in the literature of Supply Chains, but some of them are identical despite of be used distinct terms to characterize them, because different criteria for risk classification are adopted by researchers. In short, it is observed that some types of risks are identified as risk source for supply chains, such as, demand risk, environmental risk and safety risk. On the other hand, other types of risks are identified by the consequences that they can generate for the supply chains, such as, the reputation risk, the asset depreciation risk and the competitive risk. These results are consequence of the disagreements between researchers on risk classification, mainly about what is risk event and about what is the consequence of risk occurrence. An additional study is in developing in order to clarify how the risks can be generated, and which are the characteristics of the components in a Supply Chain that leads to occurrence of risk.

Keywords: sisks classification, survey, supply chain management, theoretical discussion

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Authors: Heiko Jessen, Laura Tanus, Slobodan Ruzicic

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Objectives: The efficacy of Stribild®, an integrase strand transfer inhibitor (INSTI) -based STR, has been evaluated in randomized clinical trials and it has demonstrated durable capability in terms of achieving sustained suppression of HIV-1 RNA-levels. However, differences in monitoring frequency, existing selection bias and profile of patients enrolled in the trials, may all result in divergent efficacy of this regimen in routine clinical settings. The aim of this study was to assess the virologic outcomes, safety and tolerability profile of Stribild® in a routine clinical setting. Methods: This was a retrospective monocentric analysis on HIV-1-infected patients, who started with or were switched to Stribild®. Virological failure (VF) was defined as confirmed HIV-RNA>50 copies/ml. The minimum time of follow-up was 24 weeks. The percentage of patients remaining free of therapeutic failure was estimated using the time-to-loss-of-virologic-response (TLOVR) algorithm, by intent-to-treat analysis. Results: We analyzed the data of 197 patients (56 ART-naïve and 141 treatment-experienced patients), who fulfilled the inclusion criteria. Majority (95.9%) of patients were male. The median time of HIV-infection at baseline was 2 months in treatment-naïve and 70 months in treatment-experienced patients. Median time [IQR] under ART in treatment-experienced patients was 37 months. Among the treatment-experienced patients 27.0% had already been treated with a regimen consisting of two NRTIs and one INSTI, whereas 18.4% of them experienced a VF. The median time [IQR] of virological suppression prior to therapy with Stribild® in the treatment-experienced patients was 10 months [0-27]. At the end of follow-up (median 33 months), 87.3% (95% CI, 83.5-91.2) of treatment-naïve and 80.3% (95% CI, 75.8-84.8) of treatment-experienced patients remained free of therapeutic failure. Considering only treatment-experienced patients with baseline VL<50 copies/ml, 83.0% (95% CI, 78.5-87.5) remained free of therapeutic failure. A total of 17 patients stopped treatment with Stribild®, 5.4% (3/56) of them were treatment-naïve and 9.9% (14/141) were treatment-experienced patients. The Stribild® therapy was discontinued in 2 (1.0%) because of VF, loss to follow-up in 4 (2.0%), and drug-drug interactions in 2 (1.0%) patients. Adverse events were in 7 (3.6%) patients the reason to switch from therapy with Stribild® and further 2 (1.0%) patients decided personally to switch. The most frequently observed adverse events were gastrointestinal side effects (20.0%), headache (8%), rash events (7%) and dizziness (6%). In two patients we observed an emergence of novel resistances in integrase-gene. The N155H evolved in one patient and resulted in VF. In another patient S119R evolved either during or shortly upon switch from therapy with Stribild®. In one further patient with VF two novel mutations in the RT-gene were observed when compared to historical genotypic test result (V106I/M and M184V), whereby it is not clear whether they evolved during or already before the switch to Stribild®. Conclusions: Effectiveness of Stribild® for treatment-naïve patients was consistent with data obtained in clinical trials. The safety and tolerability profile as well as resistance development confirmed clinical efficacy of Stribild® in a daily practice setting.

Keywords: ART, HIV, integrase inhibitor, stribild

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Authors: H. M. El-Askary, S. A. Abd El-Mawla, M. Allali, M. M. El-Hattab, M. El-Raey, A. M. Farahat, M. Kafatos, S. Nickovic, S. K. Park, A. K. Prasad, C. Rakovski, W. Sprigg, D. Struppa, A. Vukovic

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A clear distinction between weather and climate is a necessity because while they are closely related, there are still important differences. Climate change is identified when we compute the statistics of the observed changes in weather over space and time. In this work we will show how the changing climate contribute to the frequency, magnitude and extent of different extreme events using a multi sensor approach with some synergistic modeling activities. We are exploring satellite observations of dust over North Africa, Gulf Region and the Indo Gangetic basin as well as dust versus anthropogenic pollution events over the Delta region in Egypt and Seoul through remote sensing and utilize the behavior of the dust and haze on the aerosol optical properties. Dust impact on the retreat of the glaciers in the Himalayas is also presented. In this study we also focus on the identification and monitoring of a massive dust plume that blew off the western coast of Africa towards the Atlantic on October 8th, 2012 right before the development of Hurricane Sandy. There is evidence that dust aerosols played a non-trivial role in the cyclogenesis process of Sandy. Moreover, a special dust event "An American Haboob" in Arizona is discussed as it was predicted hours in advance because of the great improvement we have in numerical, land–atmosphere modeling, computing power and remote sensing of dust events. Therefore we performed a full numerical simulation to that event using the coupled atmospheric-dust model NMME–DREAM after generating a mask of the potentially dust productive regions using land cover and vegetation data obtained from satellites. Climate change also contributes to the deterioration of different marine habitats. In that regard we are also presenting some work dealing with change detection analysis of Marine Habitats over the city of Hurghada, Red Sea, Egypt. The motivation for this work came from the fact that coral reefs at Hurghada have undergone significant decline. They are damaged, displaced, polluted, stepped on, and blasted off, in addition to the effects of climate change on the reefs. One of the most pressing issues affecting reef health is mass coral bleaching that result from an interaction between human activities and climatic changes. Over another location, namely California, we have observed that it exhibits highly-variable amounts of precipitation across many timescales, from the hourly to the climate timescale. Frequently, heavy precipitation occurs, causing damage to property and life (floods, landslides, etc.). These extreme events, variability, and the lack of good, medium to long-range predictability of precipitation are already a challenge to those who manage wetlands, coastal infrastructure, agriculture and fresh water supply. Adding on to the current challenges for long-range planning is climate change issue. It is known that La Niña and El Niño affect precipitation patterns, which in turn are entwined with global climate patterns. We have studied ENSO impact on precipitation variability over different climate divisions in California. On the other hand the Nile Delta has experienced lately an increase in the underground water table as well as water logging, bogging and soil salinization. Those impacts would pose a major threat to the Delta region inheritance and existing communities. There has been an undergoing effort to address those vulnerabilities by looking into many adaptation strategies.

Keywords: remote sensing, modeling, long range transport, dust storms, North Africa, Gulf Region, India, California, climate extremes, sea level rise, coral reefs

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Authors: Deepa, Yashbir Singh, Shi Yi Wu, Michael Friebe, Joao Manuel R. S. Tavares, Hu Wei-Chih

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Cardiovascular disease can be detected by measuring the regional and global wall motion of the left ventricle (LV) of the heart; In this study, we designed a dynamic simulation tool using Computed Tomography (CT) images to assess the difference between actual and simulated left ventricular functions. Thirteen healthy subjects were involved in the study with actual and simulated left ventricular functions. In this research, we found the high correlation between actual left ventricular wall motion and simulated left ventricular wall motion. Our results confirm that our simulation tool is feasible for simulating left ventricular motion.

Keywords: cardiac imaging, left-ventricular remodeling, cardiac wall motion, myocardial functions

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